A surgical technique for resecting malignancies invading the facial nerve and petrous pyramid

Certain head and neck malignancies tend to invade branches of the cranial nerves and progress centripetally. The maxillary and mandibular divisions of the V (trigeminal) nerve are the most commonly invaded, but the VII (facial) nerve may harbor extensions of primary parotid malignancies and/or skin cancers originating in or near the ear. Paresis of the VII nerve signifies a serious but not entirely hopeless situation if countered with an appropriate surgical procedure. The optimal treatment of malignancies invading cranial nerves is surgical excision, which may necessitate removal of substantial portions of the cranium. Surgical pursuit of a malignancy in the facial nerve leads to a direct confrontation with the petrous pyramid of the temporal bone. Resection of the petrous pyramide is surgically feasible, but, if performed en bloc, extracts a high morbidity and mortality. An alternate technique in which the soft tissue and bones are removed disjunct is advocated. In this technique, the soft tissues are excised flush with the surface of the temporal bone. After making perforator and burr openings in the squamous temporal bone, a subtotal temporal craniectomy is completed with rongeurs. A prerequisite for success with this technique is the rotation of a large scalp flap and other local flaps to cover the exposed meninges and carotid arteries. A resume of four cases using this technique is presented. The age of the patients, the type, stage, and duration of the malignancies, and other factors which might influence the end stage results are given.     

Use of survival analysis and Classification and Regression Trees to model the growth/no growth boundary of spoilage yeasts as affected by alcohol, pH, sucrose, sorbate and temperature

This paper describes the application of a survival analysis model and a Classification and Regression Trees (CART) model to a data set comprising times to growth of a yeast cocktail inoculated into media simulating a fruit-based or alcoholic food or drink, and covering over 900 combinations of five environmental factors (alcohol, pH, sucrose, sorbate and temperature). Growth was determined as either the time to growth within a 150-day time period or as no-growth after 150 days. Models were developed which could either predict the likelihood of growth occurring within the 150 day period, or the time to grow, either in days or in one of three categories chosen to represent a rapid (1-14 days), medium (15-30 days) or slow (31-150 days) growth response. Growth was observed in 29% of the experimental conditions and demonstrated that the yeasts used were able to grow under extreme environmental conditions, for example at a pH value of 2.1, a temperature of 2 degrees C, a sucrose concentration of 55% (w/w) or an alcohol concentration of 12% (w/v). Generally, both models provided a reasonable fit to the data, and successfully predicted the growth class in 84% of cases. Direct comparisons of the models were made to determine the more suitable for predicting the growth of yeasts in food systems. The survival analysis model was preferred for this data set because it was more fail-safe than the CART model. In food validation studies, the survival model generally gave reliable predictions of time to growth in a range of 23 different food and drink products and is considered to be a reliable model to predict the likelihood and speed of yeast spoilage for a range of fruit-based or alcoholic food or drinks.     

Locus of control and mastery in a reformatory: A field study of defensive externality.

145 males (mean age 21.9 yrs) enrolled in an incentive-based reformatory were administered Rotter's Internal–External Locus of Control (LOC) Scale, Marlowe–Crowne Social Desirability Scale, and several measures of expectancy/importance of success and failure. After success or failure at mastery attempts, Ss made causal attributions derived from both J. B. Rotter's (1966) and B. Weiner's (1972) theories. Results show that internal LOC inmates, relative to externals, demonstrated greater mastery and attributed more responsibility to themselves for success, even with social desirability controlled. Defensive externality hypotheses involving both major moderators of LOC, interpersonal trust and action taking, as well as 4 proposed aspects of defensive externality were not supported. Contrary to predictions, trust-defensive externals made more internal nondefensive attributions after failure than trust-congruent externals did. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid smoking: A cautionary note.

Although rapid smoking has proved to be a successful treatment strategy for smokers, its hazard potential has been recently debated. In the present study, 6 Ss (mean age 30.8 yrs) were monitored throughout 8 standard sessions of rapid smoking. Heart rate, blood pressure, and carboxyhemoglobin increases were generally higher than those reported in the few extant physiological studies of rapid smoking, and EKG abnormalities occurred in several Ss during rapid smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychotherapeutic relationship.

This paper attempts an exhaustive review of the literature on the psychotherapeutic relationship. The nature of the ideal psychotherapeutic relationship is defined and approximations of this ideal are shown to correlate positively with various measures of patient progress in the therapeutic enterprise. Other correlates of good therapeutic relationships are then explored: patient variables, therapist variables, therapist-patient similarity, and technique variables. In all these areas, significant correlations are found, though not as often as one might expect. The research on therapist variables is especially disappointing, while patient variables seem to be quite good predictors of the quality of the ensuring patient-therapist relationship. Methodological issues are considered throughout the paper. (72 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Environmental stress and recovery: the geochemical record of human disturbance in New Bedford Harbor and Apponagansett Bay,Massachusetts (USA)

Sediments record the history of contamination to estuaries. Analysis of the concentrations of toxic organic compounds, contaminant and crustal metals, organic carbon content and isotopic composition in sediment cores from two estuarine systems in Buzzards Bay allowed reconstruction of human impacts over 350 years. Vertical distributions of the contaminants correlate with changes in the nature of watershed/estuarine activities. All contaminants were highly enriched (tens to hundreds times background) in modern New Bedford Harbor sediments. Enrichment began around the turn of the 20th century for all but PCBs, which were first synthesized in the 1930s. An increase in organic carbon content and a shift of carbon isotopes toward a more terrestrial signature illustrates increasing anthropogenic impact in New Bedford as population grew along with the industrial base. Institution of environmental protection measures in the late 20th century was reflected in decreased, although still substantially elevated, concentrations of contaminants. A lack of industrial development in Apponagansett Bay resulted in much lower concentrations of the same indicators, although specific contaminants related to the early whaling industry increased significantly above background as early as the late 18th century. The similarity of indicators in older portions of cores from NBH and unimpacted Apponagansett Bay demonstrates that cores can be used to establish reference conditions as successfully as using separate sites judged a priori to represent the reference state. The historical reconstruction approach provides the basis for establishing relationships between environmental stressors and factors that drive the stressors, as well as a framework for the assessment of ecological response(s) to environmental stressors over a range of time and/or exposure scales.     

Application of the diffusion model to two-choice tasks for adults 75-90 years old.

The effects of aging on simple 2-choice decision making was investigated with the diffusion model (R. Ratcliff, 1978). Data for 75- to 90-year-olds were collected and compared with previous data from 60- to 75-year-olds and college students for 5 tasks: a signal detection-like task, letter and brightness discrimination with masking, recognition memory, and lexical decision. The model fit the data well and therefore allows components of processing to be examined as a function of age. Compared with decision-making processes in college students, decision criteria and nondecision components of processing increased with participants' age. However, the quality of the evidence on which decisions were based decreased with age only for letter and brightness discrimination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early employer response to workplace injury: What injured workers perceive as fair and why these perceptions matter.

The authors examined whether early employer response to workplace injury affects injured workers' subsequent attitudes and mental health. At 1 month and 6 months postinjury, telephone surveys were conducted with 344 workers from Ontario, Canada, who had experienced a musculoskeletal lost-time workplace injury. One-month reports of initial supervisor reaction to the injury and the use of workplace-based return-to-work strategies (early contact with worker, ergonomic assessment, presence of designated coordinator, accommodation offer) were hypothesized to predict reports of fairness, affective commitment, and depressive symptoms measured at 6 months postinjury. Structural equation modeling supported a model wherein fairness perceptions fully mediated the relationship between early responses and injured workers' attitudes and mental health. Early contact and supervisor reactions were significant predictors of fairness perceptions. The implications for early employer response are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hematological and lipid changes in newborn piglets fed milk-replacer diets containing erucic acid

Canola oil is not presently permitted in infant formulations in the United States because of lack of information concenring the effects of feeding canola oil to the newborn. We have previously reported a transient decrease in platelet counts and an increase in platelet size in newborn piglets fed canola oil for 4 wk, and have confirmed this in the present study. In canola oil-fed piglets, changes in platelet size and number were overcome by adding either long-chain saturated fatty acids from cocoa butter (16:0 and 18:0), or shorter-chain saturates from coconut oil (12:0 and 14:0). Feeding a high erucic acid rapeseed (HEAR) oil, with 20% 22:1n−9, led to an even greater platelet reduction and increased platelet size throughout the 4-wk trial. Bleeding times were longer in piglets fed canola oil or HEAR oil compared to sow-reared and soybean oil-fed piglets. There were no other diet-related changes. Diet-induced platelet changes were not related to platelet lipid class composition, but there were fatty acid changes. The incorporation of 22:1n−9 into platelet phospholipids of piglets fed canola oil was low (0.2–1.2%), and even for the HEAR oil group ranged from only 0.2% in phosphatidylinositol to 2.4% in phosphatidylserine. A much greater change was observed in the concentration of 24:1n−9 and in the 24:1n−9/24:0 ratio in platelet sphingomyelin (SM). The 24:1n−9 increased to 49% in the HEAR oil group compared to about 12% in animals fed the control diets (sow-reared piglets and soybean oil-fed group), while the 24:1n−9/24:0 ratio increased from about 1 to 12. Even feeding canola oil, prepared to contain 2% 22:1n−9, led to a marked increase in 24:1n−9 to 29% and had a 24:1n−9/24:0 ratio of 5. The canola oil/cocoa butter group, which also contained 2% 22:1n−9, showed a lower level of 24:1n−9 (20%) and the 24:1n−9/24:0 ratio (3) compared to the canola oil group. The results suggest that the diet-related platelet changes in newborn piglets may be related to an increase in 24:1n−9 in platelet SM, resulting from chain elongation of 22:1n−9. The inclusion of canola oil as the sole source of fat in the milk-replacer diets of newborn piglets resulted in significant platelet and lipid changes.